Reimbursement For Employee-Paid Services

Notwithstanding any other provision of this rule, if an employee has personally paid for a health care service and at a later date an employer is determined to be responsible for the payment for that specific service, then the employee shall be fully reimbursed by the employer. Medical Fee Schedule maximum payments may not apply under this provision. If the service delivered is determined to be reasonable and necessary, the reimbursed expenses may exceed the maximum fee schedule amount.